Is a Single Incisional Laparoscopic Totally Extraperitoneal Approach Feasible for Inguinal Hernia Repair?

ABSTRACT

PURPOSE: This study describes our preliminary experience of a single incisional laparoscopic totally extraperitoneal approach (TEP) for inguinal hernia repair, compared to conventional TEP. METHODS: From August 2012 to February 2014, 46 patients underwent inguinal hernia repair using a laparoscopic totally extraperitoneal approach by a single surgeon at Hansol Hospital, Seoul, Korea. Three patients were excluded due to a recurrent inguinal hernia; thus, 43 patients were enrolled in two groups, the single incisional TEP (STEP) group (n=23) and the conventional TEP (CTEP) group (n=20). The mean follow-up period was 15 months. RESULTS: No differences in patient demographics (age, sex, hernia site and type, and body mass index) were detected between the two groups. The operation time in the STEP group was significantly longer than that in the CTEP group (69.7+/-28.5 vs. 51.0+/-16.4 min, p=0.017). No differences in postoperative complications were detected, including chronic pain, voiding difficulties, or the occurrence of a wound seroma (STEP, n=3 vs. CTEP, n=2). Pain scores (STEP, 1.4+/-0.7 vs. CTEP 1.4+/-0.8) and hospital stay duration (STEP, 1.0+/-0.2 vs. CTEP, 1.2+/-0.5 days) also did not differ between the groups. No patient in the STEP group required an additional port. CONCLUSION: Single incisional TEP was technically feasible, although it required a longer operation time. STEP appeared to have better cosmetic results compared with those of CTEP.